A nurse is providing education to a client during the first prenatal visit. Which of the following statements by the client should indicate to the nurse a need for clarification?

Explanation:

A. "I should drink about 2 liters of fluid each day."

This statement is generally accurate and aligned with recommendations for adequate hydration during pregnancy. The recommended daily fluid intake for pregnant individuals is typically around 8 to 10 cups of fluids per day, which is approximately 2 liters. Adequate hydration is important during pregnancy to support overall health, prevent dehydration, and maintain proper functioning of bodily systems.

B. "I can have a moderate amount of caffeine daily."

This statement is generally acceptable and aligned with guidelines from organizations such as the American College of Obstetricians and Gynecologists (ACOG). Moderate caffeine intake, typically defined as up to 200 milligrams per day, is considered safe during pregnancy for most individuals. However, it's essential to be mindful of caffeine sources and consume them in moderation, as excessive caffeine intake can have adverse effects on pregnancy outcomes.

C. "I should not drink alcoholic beverages during my pregnancy."

This statement is correct and crucial for a healthy pregnancy. Alcohol consumption during pregnancy is associated with various risks, including fetal alcohol spectrum disorders (FASDs) and developmental issues. Therefore, healthcare providers universally recommend abstaining from alcohol entirely during pregnancy to protect the health and well-being of both the mother and the developing baby.

D. "I should increase my calcium intake to 1,500 milligrams per day."

This statement indicates a need for clarification because the recommended daily intake of calcium during pregnancy is typically around 1,000 milligrams per day for most pregnant individuals. While some healthcare providers may recommend slightly higher amounts, such as up to 1,300 milligrams per day, a calcium intake of 1,500 milligrams per day is relatively high and may not align with standard recommendations without specific indications such as a history of low calcium levels or certain medical conditions. It's important for the nurse to clarify and provide accurate information regarding appropriate calcium intake during pregnancy based on the client's individual needs.

Explanation:

A. Prepare the abdominal and perineal areas: While preparing the abdominal and perineal areas may be necessary for potential interventions, such as a cesarean section or vaginal examination, it is not the priority at this moment.

B. Witness the signature for informed consent for surgery: Obtaining informed consent for surgery is important, especially if surgical intervention is anticipated. However, the priority in this case is to stabilize the client's condition and address the potential causes of painless, bright red vaginal bleeding.

C. Insert an indwelling urinary catheter: Inserting an indwelling urinary catheter may be beneficial for monitoring urinary output and assessing fluid status. However, it is not the immediate priority compared to addressing the client's vital signs and managing potential causes of bleeding.

D. Initiate IV access: This is the correct answer. Given the client's large amount of painless, bright red vaginal bleeding, the priority is to establish IV access to administer fluids and possibly blood products if there is evidence of hypovolemia or hemorrhage. IV access will also allow for the administration of medications or other interventions as needed.